A revision hip or knee replacement, also known as revision arthroplasty, is a surgical procedure to replace a failed or worn-out joint implant from a previous surgery. While primary (the first) joint replacements are highly successful, they don’t last forever. Over time, the artificial joint, or prosthesis, can wear down, become loose, or get infected, leading to pain and instability.
Think of it like the tires on your car. With time and use, they eventually need to be replaced. Similarly, a joint implant can experience wear and tear, requiring a “tune-up” in the form of a revision surgery. This procedure is more complex than the initial replacement because the surgeon needs to remove the old implant, which may have grown into the bone, and address any bone loss or damage that has occurred.
The goal of a revision is to relieve pain, restore your mobility, and improve your overall quality of life. The experienced orthopedic surgeons at California Pacific Orthopaedics specialize in these complex procedures, utilizing the latest techniques and technologies to ensure the best possible outcomes for our patients in the San Francisco Bay Area.
Why a Revision Procedure is Done
There are several reasons why a revision hip or knee replacement may be necessary. Understanding these can help you and your doctor determine if it’s the right course of action for you.
Common Reasons for Revision Surgery
- Implant Loosening and Wear: This is the most common reason for a revision. Just like your natural joints, the components of a joint replacement can wear down over time. This can cause the implant to loosen from the bone, leading to pain and a feeling of instability.
- Infection: Although rare, an infection can occur after a joint replacement, sometimes even years later. Bacteria can grow on the surface of the implant, causing pain, swelling, and stiffness. A revision surgery is often needed to remove the infected implant and surrounding tissue.
- Instability and Dislocation: If the ligaments and other soft tissues around the joint are not properly balanced, the implant may feel unstable or even dislocate. This is more common in hip replacements.
- Fracture: A fall or other injury can cause a fracture in the bone around the implant, which may require a revision to stabilize the bone and replace the damaged components.
- Implant Failure: In rare cases, the implant itself may break or fail.
If you’re experiencing any of the following symptoms, it’s important to schedule a consultation with an orthopedic specialist to determine the cause and discuss your treatment options:
- Increased pain in the affected joint
- Swelling or stiffness
- A feeling of instability or “giving way”
- Difficulty walking or performing daily activities
- A noticeable limp
What to Expect Before, During, and After the Procedure
A revision surgery is a significant undertaking, and being prepared can help ensure a smooth and successful recovery.
Before the Procedure
Once you and your surgeon have decided that a revision is the best option, you will undergo a thorough medical evaluation to ensure you are healthy enough for surgery. This may include:
- A physical exam
- Blood tests
- X-rays and other imaging studies to assess the condition of your implant and the surrounding bone
- A consultation with your primary care physician to manage any other health conditions
Your surgeon will also provide you with specific instructions on how to prepare, which may include:
- Stopping certain medications that can increase the risk of bleeding
- Quitting smoking to improve healing
- Arranging for help at home during your recovery
During the Procedure
Revision surgeries are performed under general or regional anesthesia. The procedure itself can take several hours, depending on the complexity of your case. Here’s a general overview of what happens:
- The surgeon makes an incision over your old surgical scar.
- The old implant is carefully removed.
- The bone is prepared for the new implant. This may involve removing any damaged bone and using bone grafts or metal augments to build up the bone.
- The new, specialized revision implant is put in place.
- The incision is closed, and in some cases a drain may be placed to remove excess fluid.
After the Procedure
Recovery from a revision surgery is variable based on the type of procedure that is performed. In some cases recovery is more challenging than after a primary joint replacement. You can expect to stay in the hospital overnight or for a few days. You will likely need to use a walker or crutches for several weeks. You will have a pre-operative appointment with a member of the joint-replacement surgical team to discuss recovery expectations for your specific procedure.
Physical therapy is a crucial part of your recovery. A physical therapist will work with you to regain your strength, flexibility, and range of motion. It’s important to follow your therapist’s instructions carefully to ensure the best possible outcome.
While the recovery process can be demanding, most patients experience significant pain relief and improved function after a successful revision surgery. The dedicated team at California Pacific Orthopaedics will be with you every step of the way, providing the support and guidance you need to get back on your feet.
If you are experiencing problems with your hip or knee replacement, don’t wait. Contact California Pacific Orthopaedics today to schedule a consultation with one of our expert orthopedic surgeons. We are committed to helping you find a solution that will allow you to live a full and active life.
